Adherence to and outcomes of a University-Consortium gastroschisis pathway

• Published in: Journal of pediatric surgery 2020-01, Vol.55 (1), p.45-48
• Main Authors: DeUgarte, Daniel A., Calkins, Kara L., Guner, Yigit, Kramer, Katelin, Lee, Hanmin, Uy, Cherry, Anderson, Jamie, Blanton, Aubrey, Brown, Erin, Choy, Michael, James, Gina, Love, Elyse, McGahan, John, McLennan, Amelia, Poulain, Francis, Raff, Gary, Morris, Laila Rhee, Rottkamp, Catherine, Saadai, Payam, Schrimmer, David, Tache, Veronique, Vanover, Melissa, Yeh, Jay, Allaf, M Baraa, Bruce, Kari, Day, Robert, Hameed, Afshan, Hatfield, Tamara, Jolley, Jennifer, Kiciman, Nafiz, Major, Carol, Makhoul, Joshua, Nicolau, Yona, Patberg, Elizabeth, Rumney, Pamela, Yu, Peter, Calkins, Kara, DeUgarte, Daniel, Deville, Jaime, Gutkin, Rachel, Lerman, Steven, Maykin, Melanie, Murphy, Aisling, Nguyen, Tina, Rao, Rashmi, Satou, Gary, Sklansky, Mark, Strobel, Katie, Yalda, Afshar, Alshawabkeh, Laith, Anton, Tracy, Ballas, Jerasimos, Conturie, Charlotte, Fernandez, Erika, Fernando, Aileen, Finer, Neil, Hull, Andrew, Johnson, Diana, Kim, Jae, Lamale-Smith, Leah, Laurent, Louise, Perez, Mishella, Picel, Andrew, Sanford, Diana, Tarsa, Maryam, Tran, Vy, Zhang-Rutledge, Kathy, Archbold, Katie, Berger, Victoria, Brakeman, Paul, Catenacci, Melissa, Chetty, Shilpa, Ghaffari, Neda, Gras, Joanne, Irani, Roxanna, Keller, Roberta, Kosiv, Katherine, Kramer, Katie, Lianoglou, Billie, Lucero, Jennifer, MacKenzie, Tippi, Mardy, Anne, Morgan, Tara, Murtha, Amy, Padilla, Benjamin, Peyandi, Shabnam, Phelps, Andrew, Rand, Larry, Rollins, Mark, Rosenstein, Melissa, Scudmore, Janice, Shulman, Rachel, Shum, Dorothy, Sperling, Jeffrey, Swanson, Katherine, Tesfalul, Martha, Valderramos, Stephanie, Yeaton-Massey, Amanda, Bennett, Stacie
• Format: Article
• Language: English
• Subjects: Gastroschisis; Guidelines; Nonoperative; Outcomes; Pathway; Sutureless
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2019.09.048

Our multi-institutional university consortium implemented a gastroschisis pathway in 2015 to standardize and improve care by promoting avoidance of routine intubation and paralysis during silo placement, expeditious abdominal wall closure, discontinuation of antibiotics/narcotics within 48 h of closure, and early initiation/advancement of feeds. Adherence to the gastroschisis pathway was prospectively monitored. Outcomes for the contemporary cohort (2015–2018) were compared with a historical cohort (2007–2012). Good adherence to the pathway was observed for 70 cases of inborn uncomplicated gastroschisis. The contemporary cohort had significantly lower median mechanical ventilator days (2 versus 5; p